title: Safety of spinal anesthesia in a patient with achondroplasia for cesarean section.
abstract: Controversial reports exist regarding the administration of spinal anesthesia in achondroplastic dwarfs regarding safety, dose, drug choice, in obstetric patients. Bony characteristics such as vertebral anomalies, lordosis and lumbar scoliosis, limited mouth opening and cervical spine instability make the administration of anesthesia to these patients truly a challenge. Here we demonstrate that low dose meperidine and bupivacaine spinal anesthesia in an achondroplastic parturient for cesarean section, was administered successfully after careful evaluation, consideration of risks, and awareness of potential complications.
authors.affiliation: Department of Anesthesiology, Yale University, 333 Cedar Street, New Haven, CT 06510, USA.
authors.forename: Hosni
authors.initials: H
authors.lastname: Mikhael
authors.forename: Nalini
authors.initials: N
authors.lastname: Vadivelu
authors.forename: Ferne
authors.initials: F
authors.lastname: Braveman
mesh_terms: D000130:Achondroplasia / Q000150:complications*; D000759:Adjuvants, Anesthesia / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000293:Adolescent; D000775:Anesthesia, Spinal / Q000009:adverse effects / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D002045:Bupivacaine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D002585:Cesarean Section; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008614:Meperidine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D011247:Pregnancy; D011248:Pregnancy Complications
chemical_list: D000759:Adjuvants, Anesthesia; D000779:Anesthetics, Local; D008614:Meperidine; D002045:Bupivacaine